- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05713955
OBSiDiAN in a Stapled Circular Esophagogastric Anastomosis After Ivor Lewis Esophagectomy
Evaluation of Effectiveness and Safety of Autologous BioMatrix OBSiDiAN to Enhance a Stapled Circular Esophagogastric Anastomosis After Ivor Lewis Esophagectomy in a Multicentre Randomized Controlled Trial.
Study Overview
Detailed Description
STUDY PRODUCT Autologous BioMatrix: Obsidian (medical device class III)
STUDY POPULATION Subjects ≥ 18 years and ≤ 75 years of age scheduled for elective Ivor Lewis esophagectomy for oesophageal cancer with a circular stapled intrathoracic esophagogastric anastomosis.
SAMPLE SIZE A total of 600 patients will be included in the study. 300 patients in each study arm.
ENROLEMENT PERIOD Based on an annual number of 70-80 esophagectomies in this centre, University Hospital Ghent, with inclusion of patients in other European high volume centers, we predict an enrolment period of 4 years.
PRIMARY ENDPOINT Anastomotic leak type I, II and III within 30 days post operatively. Anastomotic leak is defined according to the Esophagectomy Complications Consensus Group (ECCG).
Study Type
Phase
- Not Applicable
Contacts and Locations
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
preoperatively
- Subjects ≥ 18 years and ≤ 75 years who are willing to participate and provide written informed consent prior to any study-related procedures.
- Subjects with oesophageal carcinoma scheduled for elective minimally invasive or open Ivor Lewis esophagectomy Intra-operatively
- intrathoracic circular stapled esophagogastric anastomosis
Exclusion Criteria:
preoperatively
- Female patients who are pregnant or nursing
- Participation in another study involving investigational drugs or devices.
- Use of Avastin within 30 days prior to surgery
- ASA IV (American Society of Anesthesiologists physical status classification system: patient with severe systemic disease that is a constant threat to life)
- Patients with other malignancies
- Patients with previous esophageal or gastric surgery
- Known hypersensitivity to batroxobin and tranexamic acid.
- Hemoglobin level < 8 g/dL
- Patients on medicine containing acetylsalicylic acid not able to stop using the medicine for medical reasons 3 days before taking the blood sampling.
- Patients on clopidogrel not able to stop clopidogrel for medical reasons 7 days before blood sampling
- Patients on other platelet aggregation inhibitor therapies not able to stop using the platelet aggregation inhibitor therapies for 3 days before taking the blood sample.
Intra-operatively
- Intra-operative findings that may preclude conduct of the study procedures, such as pleural metastasis, tumor invasion in other organs, …
- Anastomosis preformed differently than the standard of care
- Excessive bleeding (>500 ml) prior to anastomosis
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: study group
For the study group, a unit of autologous BioMatrix OBSiDiAN will be produced.
Blood sample (120ml) will be taken after randomization at the ending of the abdominal phase of the surgery.
The surgeon will create an esophagogastric anastomosis, after ruling out tension or torsion.
Around 1-2ml of autologous BioMatrix OBSiDiAN will be applied on the distal/or proximal resection stump before the stapled anastomose will be created.
After firing the standard circular device and creation of a functional anastomosis, a further 2.5-3ml OBSiDiAN must be applied circumferentially on the outside on the anastomosis.
Once application is completed, a 30 seconds waiting period is required before putting the esophagus back into the surgical field (study specific).
A methylene blue leakage test or other leakage test is performed (standard of care).
If there is a leak, the anastomosis will be corrected or the completed procedure has to be done again.
|
To create OBSiDiAN BioMatrix, 120 ml of the the patient's blood is added to the processing unit.
The Vivostat® processor unit heats, separates, centrifugates to get the plasma.
Batroxobin is added.
After again processing, the result is an OBSiDian syringe filled with BioMatrix Obsidian®ASG.
This will be applied on the anastomosis
|
No Intervention: standard group
The surgeon will create an esophagogastric anastomosis, after ruling out tension or torsion.
A methylene blue leakage test or other leakage test is performed (standard of care).
If there is a leak, the anastomosis will be corrected.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Anastomotic leak
Time Frame: Absence of anastomotic leak within 30 days post operatively
|
Anastomotic leak defined according to the ECCG guidelines type I: local defect requiring no change in therapy or treated medicallly or with dietary modifications type II: localized defect requiring interventional but not surgical therapy, for example, interventional radiology drain, stent or bedside opening and packing or incision type III: localized defect requiring surgical therapy
|
Absence of anastomotic leak within 30 days post operatively
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
mortality
Time Frame: from surgery until 30 days post operative
|
in hospital mortality
|
from surgery until 30 days post operative
|
sepsis
Time Frame: from surgery until 30 day post operative
|
in hospital sepsis
|
from surgery until 30 day post operative
|
pneumonia
Time Frame: from surgery until 30 day post operative
|
in hospital pneumonia
|
from surgery until 30 day post operative
|
stricture
Time Frame: from surgery until 1 year post operative
|
stricture of the esophagogastric anastomosis
|
from surgery until 1 year post operative
|
ICU stay
Time Frame: from surgery until discharge or until the date of death from any cause, whichever came first, assessed up to 3 months
|
length of ICU stay
|
from surgery until discharge or until the date of death from any cause, whichever came first, assessed up to 3 months
|
hospital stay
Time Frame: from surgery until discharge or until the date of death from any cause, whichever came first, assessed up to 3 months
|
total hospital stay
|
from surgery until discharge or until the date of death from any cause, whichever came first, assessed up to 3 months
|
thoracic drainage volume
Time Frame: from surgery until removal of thoracic drain within the first week postoperative
|
Volume of thoracic drain
|
from surgery until removal of thoracic drain within the first week postoperative
|
thoracic drainage duration
Time Frame: from surgery until removal of thoracic drain within the first week postoperative
|
duration of thoracic drain
|
from surgery until removal of thoracic drain within the first week postoperative
|
late anastomotic leakage
Time Frame: from surgery until 90 days post operative
|
late anastomotic leakage (ECCG type I, II and III)
|
from surgery until 90 days post operative
|
inflammation WBC
Time Frame: from date of randomisation to postoperative day 5
|
post operative inflammation (WBC)
|
from date of randomisation to postoperative day 5
|
inflammation CRP
Time Frame: from date of randomisation to postoperative day 5
|
post operative inflammation (CRP)
|
from date of randomisation to postoperative day 5
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Piet Pattyn, UZ Gent
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- BC-09974
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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